Atypical American visceral leishmaniasis caused by disseminated Leishmania amazonensis infection presenting with hepatitis and adenopathy

Leishmania amazonensis is widely recognised as a cause of cutaneous leishmaniasis in Latin America, but it can also disseminate to produce atypical visceral leishmaniasis with hepatitis and lymphadenopathy. The patient, an 8-year-old Brazilian boy, presented with a febrile illness and hepatosplenome...

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Bibliographic Details
Published in:Transactions of the Royal Society of Tropical Medicine and Hygiene 2006, Vol.100 (1), p.79-82
Main Authors: Aleixo, J.A., Nascimento, E.T., Monteiro, G.R., Fernandes, M.Z., Ramos, A.M.O., Wilson, M.E., Pearson, R.D., Jeronimo, S.M.B.
Format: Article
Language:English
Subjects:
Adenomegaly
Antiprotozoal Agents - therapeutic use
Biological and medical sciences
Brazil
Child
Enzyme-Linked Immunosorbent Assay
Gastroenterology. Liver. Pancreas. Abdomen
Hepatitis
Hepatitis - drug therapy
Hepatitis - parasitology
Human protozoal diseases
Humans
Infectious diseases
Leishmania amazonensis
Leishmaniasis, Visceral - complications
Leishmaniasis, Visceral - drug therapy
Leshmaniasis
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Lymphatic Diseases - drug therapy
Lymphatic Diseases - parasitology
Male
Medical sciences
Other diseases. Semiology
Parasitic diseases
Protozoal diseases
Treatment Outcome
Visceral leishmaniasis
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Summary:Leishmania amazonensis is widely recognised as a cause of cutaneous leishmaniasis in Latin America, but it can also disseminate to produce atypical visceral leishmaniasis with hepatitis and lymphadenopathy. The patient, an 8-year-old Brazilian boy, presented with a febrile illness and hepatosplenomegaly, elevated liver enzymes and generalised adenopathy. Serological tests using antigens of L. chagasi, the typical cause of visceral leishmaniasis in Latin America, were inconclusive. Leishmania amazonensis was eventually isolated in a culture of a lymph node. The patient recovered fully after treatment with meglumine antimoniate. As this case illustrates, L. amazonensis produces a spectrum of disease that includes atypical American visceral leishmaniasis with evidence of hepatocellular injury and generalised lymphadenopathy.
ISSN:0035-9203
1878-3503
DOI:10.1016/j.trstmh.2005.06.025